Phototherapy in the elderly

Powell, James B.; Gach, J. E.

doi:10.1111/ced.12626

Cited by 29 publications

(41 citation statements)

References 15 publications

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“…Our data illustrate that antihistamine consumption is reduced following administration of NB-UVB, even in patients with psoriasis, 11 confirming the widespread observation that NB-UVB is effective to control pruritus. 24,25 Other common conditions, notably eczema 26,27 and urticaria, 28 also show good response to this treatment, thereby adding to indirect net savings by creating synergy on staff and equipment cost.…”

Section: Discussionmentioning

confidence: 99%

Narrowband ultraviolet B treatment for psoriasis is highly economical and causes significant savings in cost for topical treatments

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Narrowband ultraviolet B treatment for psoriasis is highly economical and causes significant savings in cost for topical treatments

et al. 2018

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“…Sometimes, these patients lack specific skin lesions, and no obvious cause for their chronic (often generalized) pruritus (ie chronic idiopathic pruritus) can be found. Phototherapy can effectively reduce itching in these elderly patients (by up to 80%) and has a minimal risk of acute side effects if the proper UV doses are applied and patients are closely monitored during UV treatment courses . Long‐term side effects, such as the acceleration of skin ageing or higher skin cancer risk, especially in patients with a history of excessive, lifetime sun exposure or who have already received the highest advised cumulative number of UV treatments (around 150‐200 treatments of PUVA or 300 for NB‐UVB), however, have to be considered.…”

Section: Uv Therapy In Other Diseases With Chronic Pruritusmentioning

confidence: 99%

“…Thus, UV therapy is a beneficial and relatively safe antipruritic treatment option in elderly patients who do not have pre‐existing severe UV‐induced skin damage or other skin cancer risk factors. However, all patients who receive long‐term UV treatments, irrespective of their ages, should undergo regular skin cancer surveillance …”

Section: Uv Therapy In Other Diseases With Chronic Pruritusmentioning

confidence: 99%

Is there still a role for UV therapy in itch treatment?

Legat

2019

Experimental Dermatology

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Itching is a frequent and greatly distressing symptom related to many skin and systemic diseases. New insights into the pathophysiology of itchy skin and potentially involved mediators have increased the interest in and development of new treatments that specifically act on targets involved in the transmission and perception of itching. Phototherapy has long been known and used as an effective treatment for various kinds of chronic itching. However, despite its well‐known beneficial effects, the mechanisms behind the antipruritic effect of phototherapy are less well‐known. In addition, phototherapy requires the use of expensive equipment in dermatology offices, patients must undergo repeated treatments and no large, randomized, controlled trials have yet supported the antipruritic effect of UV. Therefore, phototherapy is rarely recommended as a treatment method for chronic pruritic diseases or only used as a last recourse. However, the wide range of pruritic conditions that can be successfully treated with phototherapy, together with its low acute side effects, extremely low frequency of interactions with other medications, possibilities to combine phototherapy with other treatment modalities and the fact that patients of almost all ages—from childhood to old age, including women during pregnancy or lactation—can be treated make UV therapy advantageous over other treatments of chronic pruritus. Thus, despite the development of new targeted therapies against pruritus, UV therapy is neither outdated nor the ‘last recourse’, but should be considered early on in the treatment of chronic pruritus.

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“…5 Presence of comorbidities and polypharmacy that commonly accompany geriatric patients also require clinicians to give a lot more consideration when deciding therapy compared to the adults. To our knowledge, there are only 2 studies that evaluated phototherapy specifically in geriatric population, which are a study in Turkey by Bulur et al 6 and in the United Kingdom by Powell et al 7 Bulur et al found that mycosis fungoides was the most common indication for phototherapy in geriatric patients, presenting in 29.5% of 95 included patients, and followed by psoriasis, pruritus, and lichen planus. 6 Powell et al reported 51% of 37 included patients were diagnosed with psoriasis, followed by eczema, nodular prurigo, and pruritus.…”

Section: Discussionmentioning

confidence: 99%

The Efficacy and Safety of Narrowband Ultraviolet B Phototherapy in Geriatric Patients: A Retrospective Study

Sn¹,

Legiawati²,

Astriningrum³

et al. 2019

Journal of the Indian Academy of Geriatrics

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Background: Skin diseases can be one of the factors affecting the quality of life of the growing elderly population. In treating various dermatoses in the elderly, structural and physiological changes of the skin due to ageing need to be considered. Phototherapy has been proven to be a valuable modality for many skin diseases in adults. However, there is currently no study evaluating the use of phototherapy to treat skin diseases in geriatric population in Indonesia. Objective: To learn the efficacy and safety of narrowband ultraviolet B (NB-UVB) phototherapy in geriatric patients. Methods: A retrospective study using data from medical records of patients aged 60 years and above that received NB-UVB phototherapy in Dermatovenereology Clinic at the Dr Cipto Mangunkusumo National General Hospital in 2014–2018. Results: From 34 included patients, 21 (61.7%) patients had psoriasis, 9 (26.5%) had vitiligo, and 5 (14.7%) patients had other dermatoses. Psoriasis Area Severity Index (PASI) 75% was achieved by 52.4% psoriasis patients with a median of 22 sessions and cumulative dose of 26.6 J/cm2. Initial repigmentation was seen in 100% of vitiligo patients starting from a median of 6 sessions and a cumulative dose of 1.5 J/cm2. The side effect of erythema presented in 10 (47.6%) patients, with an event rate of 1.48% per session. Severe erythema was experienced by one vitiligo patient requiring a delay in phototherapy session. Conclusion: Phototherapy is a safe and effective modality for the geriatric population with various skin diseases, using doses and frequency similar to those of adult patients.

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Phototherapy in the elderly

Abstract: In this small survey, the first of its kind to focus on elderly patients, phototherapy appears to be well-tolerated, safe and efficacious in the short term. Further thought and investigation should be given to delivering phototherapy to an ageing population.

Cited by 29 publications

References 15 publications

Narrowband ultraviolet B treatment for psoriasis is highly economical and causes significant savings in cost for topical treatments

Narrowband ultraviolet B treatment for psoriasis is highly economical and causes significant savings in cost for topical treatments

Is there still a role for UV therapy in itch treatment?

The Efficacy and Safety of Narrowband Ultraviolet B Phototherapy in Geriatric Patients: A Retrospective Study

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